chlamydia cours de bactériologie de 2022.pptx

Ce cours nous décrit le chlamydia

1. Chlamydia Emilia Enjema Lyonga (MPH, PhD) Faculty of Medicine and Biomedical Sciences, University of Yaounde 1

2. Objectives Discribe the bacteriological characteristics Know the pathogenecity Know the characteristics used for identification Know the antimicrobial susceptibility profile

3. Family: Chlamydiaceae Genus: Chlamydia C. trachomatis Urogenital infections, Trachoma, Conjunctivitis, Pneumonia, Lymphogranuloma venerium (LGV) C. psittaci Pneumonia (Psittacosis) C. pneumoniae Bronchitis, sinusitis, Pneumonia

4. Chlamydia- Microbiology Small obligate intracellular parasites Contain DNA, RNA and ribosomes Gram Negative cell wall Cell wall not well characterized Inner and outer membrane LPS but no peptidoglycan Dependant on energy molecules Can’t make ATP

5. Physiology and Structure Two morphological forms Elementary body Reticulate body

6. Physiology and Structure Elementary bodies (EB) Small (0.3 - 0.4 µm), Extracellular Rigid outer membrane, Resistant Non-replicating, non-metabolically active Infectious Bind to columnar epithelial cells / Macrophages

7. Physiology and Structure Reticulate bodies (RB) Larger (0.8 - 1 µm) Intracellular Fragile membrane Metabolically active Replicating Non-infectious

8. Developmental Cycle of Chlamydia EB bind to host cells Epithelial cell Macrophage Internalization Endocytosis Phagocytosis Inhibition of phagosome- lysosome fusion Reorganization into RB Growth of RB by binary fission

9. Developmental Cycle of Chlamydia Reorganization into EB Inclusion bodies Release of EB Lysis - C. psittaci Extrusion – C. trachoma and C. pneumoniae

10. Chlamydia trachomatis Trachoma Inclusion conjunctivitis Pneumonia in infants Urogenital infections Reiter’s Syndrome Lymphogranuloma venerium ( LGV )

11. C. trachomatis Biovars - biological variants Trachoma LGV Serovars - serological variants Major outer membrane proteins A through L

12. C. trachomatis - Serovars

13. Pathogenesis and Immunity ( C. trachomatis ) Infects epithelial cells / Macrophages Down regulation of Class I MHC Infiltration of PMNs and lymphocytes Lymphoid follicle formation Fibrosis Disease results from destruction of cells and host immune response No long lasting immunity; reinfection results in inflammatory response

14. C. trachomatis - Epidemiology Trachoma Worldwide Poverty and overcrowding Endemic in Africa, Middle East, India, SE Asia Infection of children Transmission : droplets, hands, contaminated clothing, flies, contaminated birth canal

15. C. trachomatis - Epidemiology Genital tract infections Biovar: Trachoma STD s 50 million new cases/year worldwide Biovar: LGV Prevalent in Africa, Asia and South America

16. T r a c hom a Chronic or repeated infection Follicle formation on conjunctiva Scarring of the conjunctiva

17. T r a c h o m a Eyelids turn in and abrade cornea Ulceration Scarring Blood vessel formation

18. T r a c h o m a Flow of tears impeded – Secondary infections

19. Trachoma

20. Inclusion Conjunctivitis ( C. trachomatis ) Associated with genital C hlamydia Mucopurulent discharge Corneal infiltrates, vascularization and scarring can occur In neonates infection results from infected birth canal Apparent 5-12 days after birth Ear infection and rhinitis often accompany ocular disease

21. Infant Pneumonia ( C. trachomatis biovar: trachoma) Associated with genital C hlamydia Infection arises from contaminated birth canal Wheezing cough and pneumonia but no fever Often preceded by conjunctivitis

22. Urogenital Infections ( C. trachomatis ) Females Asymptomatic (80%) Cervicit i s, urethritis and salpingitis Postpartum fever Increased rate Premature d elivery Ectopic pregnancy

23. Urogenital Infections ( C. trachomatis ) Males Symptomatic (75%) Urethritis, dysuria and pyuria Cause of nongonococcal urethritis (35 - 50%) Common cause of postgonococcal urethritis

24. Reiter’s Syndrome Conjunctivitis, polyarthritis and genital or gastrointestinal inflammation Associated with HLA-B27 50 - 65 % have C. trachomatis infection 80% have antibodies to C. trachomatis

25. Lymphogranuloma Venereum (LGV ) C. trachomatis Sexually Transmitted First stage Small painless vesicular lesion at infection site Fever, headache and myalgia Second stage Inflammation of draining lymph nodes Fever, headache and myalgia Buboes (rupture and drain) Proctitis Ulcers or Elephantiasis

26. Patient with LGV Bilateral inguinal buboes (arrows)

27. C. trachomatis Diagnosis Cytology Intracellular Inclusion body Culture HeLa, Mc Coy cell line Yolk Sac Chick embryo Iodine staining inclusions Iodine-stained inclusion bodies

28. C. trachomatis - Diagnosis Antigen detection (ELISA or IF) Group specific LPS Strain specific outer membrane proteins Serology CF, ELISA, MIF Can’t distinguish between current or past infection Detection of high titer IgM antibodies can be helpful Nucleic acid probes Several kits available May eventually replace culture

29. C. trachomatis - Treatment and Prevention Tetracycline, erythromycin and sulfonamides Vaccines are of little value Treatment coupled with improved sanitation Safe sexual practices Treatment of patients and their sexual partners

30. Chlamydophilia (Chlamydia) psittaci Psittacosis (Parrot fever) Ornithosis

31. Pathogenesis - C. psittaci Inhalation of organisms in bird droppings Person to person transmission is rare Hematogenous spread to spleen and liver Local necrosis of tissue Hematogenous spread to lungs and other organs Lymphocytic inflammatory response Edema, infiltration of macrophages, necrosis and occasionally hemorrhage Mucus plugs may develop in alveoli Cyanosis and anoxia

32. Epidemiology - C. psittaci Organisms present in birds (symptomatic or asymptomatic) Tissue, feces, feathers Primarily an occupational disease Veterinarians, poultry workers, zoo keepers, pet shop workers

33. Ornithosis U n c omplica t e d I n f e c t i on Incubation period 1-2 weeks Fever, chills, headache, nonproductive cough, mild pneumonitis Recovery 5-6 weeks

34. Ornithosis Complicated Infection Incubation period 1-2 weeks Fever, chills, headache, nonproductive cough, mental confusion, pneumonitis, cyanosis, jaundice Prolonged Recovery 7-8 weeks

35. Laboratory Diagnosis - C. psittaci Serology (Complement fixation test) – Fourfold rise in titer

36. Treatment and Prevention - C. psittaci Tetracycline or erythromycin Quarantine of imported birds Control of bird infection – Antibiotic supplementation of food

37. Chlamydophilia (Chlamydia) pneumoniae TWAR agent – Taiwan (TW-183) and acute respiratory isolate (AR-39) Atypical pneumonia Atherosclerosis ?

38. Pathogenesis - C. pneumoniae Person to person spread – Respiratory droplets Bronchitis, sinusitis and pneumonia

39. Epidemiology - C. pneumoniae Common infection (200,000 - 300,000 cases per year) Primarily in adults Most infections are asymptomatic Associated with crowded conditions : Schools, military bases Association with atherosclerosis Organisms in diseased arteries Antibodies

40. Clinical Syndrome - C. pneumoniae Mild or asymptomatic disease Pharyngitis, bronchitis, persistent cough and malaise Pneumonia may develop – Usually a single lobe

41. Laboratory Diagnosis - C. pneumoniae Serology – Fourfold rise in titer

42. Treatment and Prevention - C. pneumoniae Tetracycline or erythromycin Difficult to prevent transmission No vaccine

43. Treatment Quality of ATB: Penetrate into the infected cells , maintain high concentration in the cell for long period > Cycle of Chlamydia. No cellwell inhibitors 44

44. Treatment Chlamydia trachomatis: Simple urogenital Infections 1st line : azithromycine (7 days ) Alternative : érythromycin , ofloxacin Comlicated urogenital Infections Same antibiotics (14-21 days ) Association of ATB if salpingite LGV: doxycycline for 21 jours 45

45. Treatment Chlamydia pneumoniae : Macrolides ( Azithromycine, roxithromycin , clarithromycine, dirithromycine ) for 14 days Chlamydia psittaci : Érythromycine; Cyclines for 14-21 days 46

46. Prophylaxis Uro-genital Infections Faithfulness Abstinence Use of preservatives Occular Infections Hand Hygiene Body Hygiene Wash your face Eye drop at birth 47

47. Conclusion Chlamydia = current infection/ germ given its impact and Its epidemiology : All countries have programmes to fight against STI Biological diagnosis require more precise tools from simple serodiagnosis through IF, cell culture and molecular biology The sensitivity to AB facilitate its treatment 48

48. Références bibliographiques Infections urogénitales liées aux Chlamydia et aux mycoplasmes ; Sophie FOURMAUX, Christiane BEBEAR Laboratoire de Bactériologie, Hôpital Pellegrin, Bordeaux. Progrès en Urologie (1997), 7, 132-136 Précis de bactériologie clinique. J.freney , R.quentin , renaud f.n.r . ed ESKA paris 2000. pp 1663 – 1674 49

49. QUESTIONS??? Thank you very much for your attention

50. GOD BLESS YOU AS YOU STUDY